Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards_West China Medical Journal

Authors：

ZHANG Yan ¹ , HUANG Guofei ² ,  LIU Hang ¹

1. Daytime Diagnosis and Treatment Center, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
2. Department of Vascular Surgery, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;

Corresponding?author：

LIU Hang, Email: liuhanghoney@163.com

Keywords：

Day surgery; venous thromboembolism prevention and control; ward management; risk factor

DOI：

10.7507/1002-0179.202411310

Video：

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Objective To observe the effectiveness of prevention and management of venous thromboembolism (VTE) in the day surgery wards, analyze the influencing factors of VTE occurrence in postoperative patients, in order to reduce the occurrence of VTE adverse events, improve the utilization of medical resources, and enhance the quality of day care. Methods The patient data of the Daytime Diagnosis and Treatment Center of Deyang People’s Hospital between January 2020 and December 2023 were retrospectively selected. According to the implementation time of VTE prevention and control in the day surgery wards, patients between 2022 and 2023 were selected as the observation group, and patients between 2020 and 2021 were selected as the control group. The incidence and the influencing factors of postoperative of VTE were compared between the two groups. Results A total of 2 300 patients were included, with 1 150 cases in each group. The comparison of in-hospital [12 cases (1.0%) vs. 3 cases (0.3%)] and post discharge [7 cases (0.6%) vs. 1 case (0.1%)] VTE incidence rates between the control group and the observation group showed statistically significant differences (P＜0.05). Among the 9 specialties in the Daytime Diagnosis and Treatment Center, the incidence of VTE in thoracic surgery (1.58%), vascular surgery (1.51%), and hepatobiliary surgery (1.29%) ranked among the top 3. The results of multiple logistic regression analysis showed that fourth grade surgery, lower limb surgery, and large intraoperative bleeding (>100 mL) were the influencing factors for postoperative VTE (P<0.05). Conclusions There are many reasons for VTE occurrence, and it is necessary to prevent and treat VTE in the day surgery ward. More attention should be paid to the patient’s surgical grading, intraoperative bleeding volume, and surgical site.

Citation： ZHANG Yan, HUANG Guofei, LIU Hang. Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards. West China Medical Journal, 2025, 40(2): 223-228. doi: 10.7507/1002-0179.202411310 Copy

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3.	徐蕾, 劉小南, 俞德梁, 等. 基于日間模式的手術患者當日出院的影響因素分析. 華西醫學, 2022, 37(2): 194-198.
4.	方路, 黃明君, 戴燕, 等. 四川大學華西醫院日間手術圍手術期鎮痛管理規范. 華西醫學, 2023, 38(2): 284-287.
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6.	劉迎軍, 潘昭錦, 李大軍, 等. 行擇期手術非小細胞肺癌患者出院后靜脈血栓栓塞癥發生風險的影響因素研究. 臨床腫瘤學雜志, 2024, 29(8): 770-773.
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10.	劉堅軍, 董智慧, 符偉國. 普通外科圍手術期靜脈血栓栓塞癥防治中血管外科干預原則與策略. 中國實用外科雜志, 2020, 40(5): 515-519.
11.	上海市普通外科臨床質量控制中心. 上海市普通外科住院病人靜脈血栓栓塞癥防治管理規范. 中國實用外科雜志, 2018, 38(3): 245-249.
12.	王喬宇, 武明芬, 柳鑫, 等. 2021 中國靜脈血栓栓塞癥防治抗凝藥物的選用與藥學監護指南. 中國臨床藥理學雜志, 2021, 37(21): 2999-3016.
13.	李燕如, 林茜, 胡曉燕. 結直腸癌患者術后并發靜脈血栓栓塞的相關影響因素及預防措施分析. 醫學理論與實踐, 2023, 36(8): 1327-1329.
14.	姚靈琦, 常嘯巖, 沈志平, 等. 全孔機器人與胸腔鏡在ⅠA 期非小細胞肺癌肺葉切除術中療效比較的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2023, 30(10): 1390-1395.
15.	曲哲, 吳志宏, 郭開今. 下肢大關節手術圍手術期抗凝治療. 協和醫學雜志, 2019, 10(6): 633-638.
16.	侯飛飛, 呂富榮, 王曉慧, 等. 腹腔鏡與開腹手術術后靜脈血栓栓塞癥的臨床分析. 重慶醫科大學學報, 2016, 41(1): 102-105.
17.	Alshahwani AA, Dungey M, Lillie C, et al. Predictive value of the risk assessment and prediction tool (RAPT) score for primary hip and knee arthroplasty patients: a single-center study. Cureus, 2021, 13(3): e14112.
18.	Lieberman JR. Deep vein thrombosis prophylaxis: state of the art. J Arthroplasty, 2018, 33(10): 3107-3108.
19.	Shaikhouni A, Baum J, Lonser RR. Deep vein thrombosis prophylaxis in the neurosurgical patient. Neurosurg Clin N Am, 2018, 29(4): 567-574.
20.	Morris RJ. Research quality in the study of mechanical methods of deep vein thrombosis prophylaxis. Phlebology, 2020, 35(5): 297-304.
21.	中國胸外科靜脈血栓栓塞癥研究組. 中國胸部惡性腫瘤圍手術期靜脈血栓栓塞癥預防與管理指南(2022 版). 中華外科雜志, 2022, 60(8): 721-731.
22.	王曉偉, 萬雷, 劉曉燕, 等. 脊柱外科手術后靜脈血栓栓塞的研究進展. 中華骨與關節外科雜志, 2024, 17(5): 474-479.
23.	鄭毅雋, 羅哲. 從重癥監護角度思考普通外科圍手術期靜脈血栓栓塞癥防治. 中國實用外科雜志, 2020, 40(5): 527-531.
24.	薛培君, 李宜瑤, 張婷, 等. 老年胸腔鏡術后發生靜脈血栓栓塞癥患者臨床特征及預后分析. 中華老年多器官疾病雜志, 2023, 22(2): 103-109.
25.	四川天府新區醫學會日間護理專業委員會. 日間手術病房“平急結合”管理模式專家共識. 華西醫學, 2024, 39(2): 173-177.
26.	畢偉, 袁濤, 張蘭英. 血管外科在 VTE 防治中的作用. 血管與腔內血管外科雜志, 2021, 7(10): 1145-1147, 1144.

1. Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2. 嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 2020, 40(2): 199-202.
3. 徐蕾, 劉小南, 俞德梁, 等. 基于日間模式的手術患者當日出院的影響因素分析. 華西醫學, 2022, 37(2): 194-198.
4. 方路, 黃明君, 戴燕, 等. 四川大學華西醫院日間手術圍手術期鎮痛管理規范. 華西醫學, 2023, 38(2): 284-287.
5. 秦小莉, 藕順龍, 高秀容, 等. 靜脈血栓栓塞癥風險評估工具的系統評價. 中國循證醫學雜志, 2024, 24(6): 700-707.
6. 劉迎軍, 潘昭錦, 李大軍, 等. 行擇期手術非小細胞肺癌患者出院后靜脈血栓栓塞癥發生風險的影響因素研究. 臨床腫瘤學雜志, 2024, 29(8): 770-773.
7. 許琦, 楊春建, 陳春麗. 住院患者下肢深靜脈血栓形成預防的現狀及其相關因素分析. 血管與腔內血管外科雜志, 2024, 10(6): 729-733.
8. Li H, Zhang W, Lu Q, et al. Which frequency of ankle pump exercise should be chosen for the prophylaxis of deep vein thrombosis?. Inquiry, 2022, 59: 469580221105989.
9. 上海市肺栓塞與深靜脈血栓防治聯盟. 下肢孤立性遠端深靜脈血栓超聲檢查實踐: 上海專家建議. 中華超聲影像學雜志, 2021, 30(12): 1013-1017.
10. 劉堅軍, 董智慧, 符偉國. 普通外科圍手術期靜脈血栓栓塞癥防治中血管外科干預原則與策略. 中國實用外科雜志, 2020, 40(5): 515-519.
11. 上海市普通外科臨床質量控制中心. 上海市普通外科住院病人靜脈血栓栓塞癥防治管理規范. 中國實用外科雜志, 2018, 38(3): 245-249.
12. 王喬宇, 武明芬, 柳鑫, 等. 2021 中國靜脈血栓栓塞癥防治抗凝藥物的選用與藥學監護指南. 中國臨床藥理學雜志, 2021, 37(21): 2999-3016.
13. 李燕如, 林茜, 胡曉燕. 結直腸癌患者術后并發靜脈血栓栓塞的相關影響因素及預防措施分析. 醫學理論與實踐, 2023, 36(8): 1327-1329.
14. 姚靈琦, 常嘯巖, 沈志平, 等. 全孔機器人與胸腔鏡在ⅠA 期非小細胞肺癌肺葉切除術中療效比較的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2023, 30(10): 1390-1395.
15. 曲哲, 吳志宏, 郭開今. 下肢大關節手術圍手術期抗凝治療. 協和醫學雜志, 2019, 10(6): 633-638.
16. 侯飛飛, 呂富榮, 王曉慧, 等. 腹腔鏡與開腹手術術后靜脈血栓栓塞癥的臨床分析. 重慶醫科大學學報, 2016, 41(1): 102-105.
17. Alshahwani AA, Dungey M, Lillie C, et al. Predictive value of the risk assessment and prediction tool (RAPT) score for primary hip and knee arthroplasty patients: a single-center study. Cureus, 2021, 13(3): e14112.
18. Lieberman JR. Deep vein thrombosis prophylaxis: state of the art. J Arthroplasty, 2018, 33(10): 3107-3108.
19. Shaikhouni A, Baum J, Lonser RR. Deep vein thrombosis prophylaxis in the neurosurgical patient. Neurosurg Clin N Am, 2018, 29(4): 567-574.
20. Morris RJ. Research quality in the study of mechanical methods of deep vein thrombosis prophylaxis. Phlebology, 2020, 35(5): 297-304.
21. 中國胸外科靜脈血栓栓塞癥研究組. 中國胸部惡性腫瘤圍手術期靜脈血栓栓塞癥預防與管理指南(2022 版). 中華外科雜志, 2022, 60(8): 721-731.
22. 王曉偉, 萬雷, 劉曉燕, 等. 脊柱外科手術后靜脈血栓栓塞的研究進展. 中華骨與關節外科雜志, 2024, 17(5): 474-479.
23. 鄭毅雋, 羅哲. 從重癥監護角度思考普通外科圍手術期靜脈血栓栓塞癥防治. 中國實用外科雜志, 2020, 40(5): 527-531.
24. 薛培君, 李宜瑤, 張婷, 等. 老年胸腔鏡術后發生靜脈血栓栓塞癥患者臨床特征及預后分析. 中華老年多器官疾病雜志, 2023, 22(2): 103-109.
25. 四川天府新區醫學會日間護理專業委員會. 日間手術病房“平急結合”管理模式專家共識. 華西醫學, 2024, 39(2): 173-177.
26. 畢偉, 袁濤, 張蘭英. 血管外科在 VTE 防治中的作用. 血管與腔內血管外科雜志, 2021, 7(10): 1145-1147, 1144.

West China Medical Journal

Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards

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